Individual
GRACIE GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 697-3600
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
(904) 697-4100
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA1050
FL
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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